An examination of subgroup classification in irritable bowel syndrome patients over time: a prospective study.

Penny, Kay I; Smith, Graeme D; Steinke, Douglas T; Kinnear, Moira; Penman, Iain; Ramsay, D

Abstract

Abstract
Background
Irritablebowel syndrome (IBS) is a complex functional gastrointestinal disorder which to date remains poorly understood. Therapies for irritablebowel syndrome (IBS) patients are usually aimed at relieving the predominant symptom; however, little evidence exists as to whether or not the predominant symptom changes with time. Nurses are becoming increasingly involved in the assessment and management of IBS patients.

Objectives
To categorise IBS patients into one of three sub-types, namely diarrhoea-predominant, constipation-predominant and a third group who alternate between the two, and to investigate changes in patient sub-type classification over time.

Design
Observational cohort study.

Setting
The general population of the United Kingdom (UK).

Methods
A cohort of 494 IBS patients, with a confirmed Rome II classification diagnosis, was recruited in the UK. Patients’ IBS symptoms were recorded throughout a 26-week period. Proportions of individuals in each IBS subgroup were calculated and probabilities of moving from one subgroup to another between consecutive weeks were estimated.

Results
The percentage of patients given an overall subgroupclassification of diarrhoea-predominant IBD (D-IBS) is 40.9%; 58.1% and 1% were classified as belonging to the alternator (A-IBS) and constipation-predominant (C-IBS) subgroups, respectively.

Patients
classified as an alternator or as diarrhoea-predominant have a high probability (0.67 and 0.71, respectively) of remaining in the same subgroup; however this probability is lower for constipation-predominant patients (0.35

Citation

Penny, K. I., Smith, G. D., Steinke, D. T., Kinnear, M., Penman, I., & Ramsay, D. (2008). An examination of subgroup classification in irritable bowel syndrome patients over time: a prospective study. International Journal of Nursing Studies, 45, 1715-1720. doi:10.1016/j.ijnurstu.2008.04.004

• Journal Article Type: Article
• Publication Date: 2008-12
• Deposit Date: Mar 27, 2012
• Print ISSN: 0020-7489
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 45
• Pages: 1715-1720
• DOI: https://doi.org/10.1016/j.ijnurstu.2008.04.004
• Keywords: Irritable bowel syndrome; subgroup classification; subgroup change ; medical statistics.
• Public URL: http://researchrepository.napier.ac.uk/id/eprint/5168
• Publisher URL: http://dx.doi.org/10.1016/j.ijnurstu.2008.04.004